Examination for gynecomastia

Physical examination method to distinguish gynecomastia, due to enlargement of the glandular tissue, from pseudogynecomastia, due to excessive adipose tissue. The thumb and forefinger are placed on opposite sides of the breast and slowly brought together towards the areolar-nipple complex. Gynecomastia is appreciated as a concentric, rubbery-to-firm disk of tissue, often mobile, located directly beneath the areolar area. Pseudogynecomastia presents no discrete mass, and other masses due to disorders such as cancer tend to be eccentrically positioned (insert).